Even though there are requirements and proven benefits for starting home healthcare on time, about 30% of people’s care is delayed. People living in the most underserved areas had a 13% higher risk for delayed care compared to those in the least disadvantaged areas, according to findings from a new study.

Compared to patients who received a timely visit (within 48 hours after hospital discharge), those with delays were more likely to be over 80 years old, non-Hispanic Black or Hispanic and living in more disadvantaged neighborhoods, the data showed.

The report was published Tuesday in the Journal of the American Geriatrics Society. The team examined data based on newly admitted home healthcare patients who were discharged from hospitals in 2021 and 2022.

Data came from a home healthcare agency in New York City. There were 73,536 home healthcare episodes of care and 32.3% experienced delays, which was defined as not receiving a visit until 48 hours after discharge. Then the team examined neighborhood disadvantages and adjusted for factors like age, race, sex and clinical status.

Data showed that the risk of delayed care rose as the level of neighborhood disadvantage increased. Data also showed that episodes with delayed visits had a higher proportion of patients who were dual-eligible for Medicare and Medicaid, lived alone and had no or limited availability of assistance compared to those who did not experience delayed visits.

Delays are linked to negative outcomes including emergency department visits, hospitalizations and death, the authors pointed out.

“These findings underscore the disparities in receipt of timely home healthcare among differing levels of neighborhood disadvantage,” the authors wrote.

Home healthcare is promoted as a more comfortable alternative to institutional post-acute care, but it needs to be equitable to maintain high care standards in already marginalized populations, the authors added.